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See a sample rate comparisonCPT 13122 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Cmplx Rpr S A L Addl 5 Cm, Repair Complex Scalp Arms And Or Legs Each Additional 5 Cm Or Less List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service XS - Separate Structure |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 13122 |
| Medicaid Fee Schedule | View Medicaid rates for 13122 |
National average reimbursement for CPT 13122 by major payers:
$151.78
$162.87
$168.39
$201.09
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CPT 13122
5 of 25 sample ratesHigher to lower in this preview
River Drive Surgery Center, LLC, River Drive Surgery And Laser Center
River Drive Surgery Center L L
$1,708.00Published rateBloomington Normal Healthcare, LLC
Bloomington-Normal Healthcare, L.L.C.
$567.00Published rateSurgicare Of Minneapolis Ltd, Surgical Specialty Center Of Minnesota
$347.00Published rateGeorgia Vascular & Vein Center
Georgia Vascular Vein Center
$123.00Published rateLaurel Laser & Surgery Center, L.P.
Laurel Laser Surgery Center Lp
$64.00Published rate
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See a sample payer proposalCPT 13122 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13122 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 13122 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 12020-CPT | Moderate | Re-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage. |
| 13120-CPT | Moderate | Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue From A Wound On The Scalp Arms Or Legs. The Wound Is Stitched Closed In Layers. |
| 13121-CPT | Moderate | Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue From A Wound On The Scalp Arms Or Legs. The Wound Is Stitched Closed In Layers. |
| 13122-CPT | Low | Cmplx Rpr S A L Addl 5 Cm, Repair Complex Scalp Arms And Or Legs Each Additional 5 Cm Or Less List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13122 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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